Incidence and mortality

Two in three Australians will be diagnosed with skin cancer by the time they are 70.

Over the past decades, the incidence of skin cancer has risen in Australia. From 1982 to 2010 melanoma diagnoses increased by around 60%. From 1998 to 2007, GP consultations to treat non-melanoma skin cancer increased by 14%, to reach 950,000 visits each year.

Non-melanoma skin cancer is the most common type of skin cancer. This type of skin cancer is more common in men, with almost double the incidence compared to women. Over 434,000 people are treated for one or more non-melanoma skin cancers in Australia each year.

Excluding non-melanoma skin cancer, melanoma is the third most common cancer in both Australian women and men, and the most common cancer in Australians aged 15-44 years. In 2011, 11,570 people in Australia were diagnosed with melanoma.

In 2012, 2,036 people died from skin cancer in Australia. The majority of these deaths were due to melanoma, with 1,515 deaths from melanoma that year, compared with 521 deaths from non-melanoma skin cancers. The five-year relative survival rate for melanoma is 90% for Australian men and 94% for Australian women.

Symptoms and diagnosis

The sooner a skin cancer is identified and treated, the better your chance of avoiding surgery or, in the case of a serious melanoma or other skin cancer, potential disfigurement or even death.

It is also a good idea to talk to your doctor about your level of risk and for advice on early detection.

Become familiar with the look of your skin, so you pick up any changes that might suggest a skin cancer. Look for:

any crusty, non-healing sores

small lumps that are red, pale or pearly in colour

new spots, freckles or any moles changing in colour, thickness or shape over a period of weeks to months (especially those dark brown to black, red or blue-black in colour).

If you notice any changes consult your doctor.Your doctor may perform a biopsy (remove a small sample of tissue for examination under a microscope) or refer you to a specialist if he/she suspects a skin cancer.

Causes

Australia has one of the highest rates of skin cancer in the world. Anyone can be at risk of developing skin cancer, though the risk increases as you get older.

The majority of skin cancers in Australia are caused by exposure to UV radiation in sunlight.

Sunburn

Sunburn causes 95% of melanomas, the most deadly form of skin cancer.

In Australia, almost 14% of adults, 24% of teenagers and 8% of children are sunburnt on an average summer weekend. Many people get sunburnt when they are taking part in water sports and activities at the beach or a pool, as well gardening or having a barbeque.

Sunburn is also common on cooler or overcast days as many people mistakenly believe UV radiation is not as strong. This is untrue – you can still be sunburnt when the temperature is cool.

Sun exposure that doesn't result in burning can still cause damage to skin cells and increase your risk of developing skin cancer. Evidence suggests that regular exposure to UV radiation year after year can also lead to skin cancer.

Tanning

A tan is not a sign of good health or wellbeing, despite many Australians referring to a ‘healthy tan’. Almost half of Australian adults still hold the misguided belief that a tan looks healthy.

Tanning is a sign that you have been exposed to enough UV radiation (from the sun or solarium) to damage your skin. This will eventually cause loss of elasticity (wrinkles), sagging, yellowish discolouration and even brown patches to appear on your skin. Worst of all, it increases your risk of skin cancer.

A tan will offer limited protection from sunburn, but usually no more than SPF4, depending on your skin type. It does not protect from DNA damage, which can lead to skin cancer.

Some people who use fake tans mistakenly believe that a tan will provide them with protection against UV radiation. As a result, they may not take sun protection measures, putting them at greater risk of skin cancer. More information about fake tans is available in Cancer Council's position statement on fake tans.

Solariums

Solariums emit UVA and UVB radiation, both known causes of cancer. Cancer Council Australia does not recommend solarium use for cosmetic tanning under any circumstances.

Prevention

Protect your skin

For best protection, we recommend a combination of sun protection measures:

Slip on some sun-protective clothing – that covers as much skin as possible

Slop on broad spectrum, water resistant SPF30+ sunscreen. Put it on 20 minutes before you go outdoors and every two hours afterwards. Sunscreen should never be used to extend the time you spend in the sun.

Slap on a hat – that protects your face, head, neck and ears

Seek shade

Slide on some sunglasses – make sure they meet Australian Standards

Be extra cautious in the middle of the day when UV levels are most intense.

For further information please read our position statements on eye protection.

Issued by the Bureau when they forecast a UV Index for the day of three or above, the SunSmart UV Alert identifies the times during the day when sun protection will be needed.

Applying sunscreen

Apply sunscreen liberally – at least a teaspoon for each limb, front and back of the body and half a teaspoon for the face, neck and ears. Most people don’t apply enough sunscreen resulting in only 50-80% of the protection stated on the product.

Sun protection and babies

Evidence suggests that childhood sun exposure contributes significantly to your lifetime risk of skin cancer. Cancer Council Australia recommends keeping babies out of the sun as much as possible for the first 12 months.

Where this is not possible, parents and carers should minimise exposure by:

Planning the day’s activities outside the middle of the day when UV levels are most intense.

Cover as much skin as possible with loose fitting clothes and wraps made from closely woven fabrics.

Choosing a hat that protects the baby’s face, neck and ears.

Make use of available shade or create shade for the pram, stroller or play area. The material should cast a dark shadow. The baby will still need to be protected from scattered and reflected UV radiation.

Keep an eye on the baby’s clothing, hat and shade to ensure they continue to be well-protected.

Apply a broad spectrum, water resistant sunscreen to small areas of the skin that cannot be protected by clothing, such as the face, ears, neck and hands, remembering to reapply the sunscreen every two hours or more often it is wiped or washed off.

There is no evidence that using sunscreen on babies is harmful, although some babies may develop minor skin irritation. Try sunscreen milks or creams for sensitive skin which are less likely to irritate the skin. As with all products, use of any sunscreen should cease if any unusual reaction occurs.

Treatment

Skin cancers are almost always removed. In more advanced skin cancers, some of the surrounding tissue may also be removed to make sure that all of the cancerous cells have been taken out.

Common skin cancers can be treated with ointments or radiation therapy. They can also be removed with surgery (usually under a local anaesthetic), cryotherapy (using liquid nitrogen to rapidly freeze the cancer off), curettage (scraping) or cautery (burning).

Australian Institute of Health and Welfare. Health system expenditures on cancer and other neoplasms in Australia, 2000-2001. AIHW cat.no. HWE 29. Australian Institute of Health and Welfare, :Canberra, Australia 2005.